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This Information applies only to active Carpenters who are Eligible
Individuals or would be eligible Individuals if the lag month between a work quarter and an
eligibility quarter did not exist and are not covered by
any state disability insurance program (commonly called SDI)
involving employer and/or employee contributions. COBRA and most Special
Class Employees are not covered under the Weekly Disability Benefit
regardless of whether or not they are covered by any SDI or similar
program. Disability benefits are also not payable to participants who are
receiving a pension benefit from any Carpenters Pension Plan.
WHAT ARE THE BENEFITS?
If a Carpenter becomes disabled as a result of sickness
or accidental bodily injury, and as a result of such disability he/she is
“unable to work,” the Plan will pay him/her $150 per week (minus FICA
deductions). The weekly benefit amount will be prorated for partial weeks
of disability. Benefits will be paid only if the Carpenter becomes
disabled while in Eligible Individual status under the Plan or would be in
Eligible Individual status if it were not for the lag month between work
quarter and eligibility quarter.
For a Carpenter, “unable to work” means being unable to
perform work described in the applicable collective bargaining agreement.
Benefit payments will begin on the eighth day of
disability and will continue only for the duration of the disability but
not to exceed a maximum of 26 weeks for any one period of disability.
Benefits will only be paid based on the 1st 30 days of
disability, regardless of a longer period of time as may be indicated on
the original disability form. In order for additional benefits to be paid,
the member must have his doctor complete one of the extension forms, for
every month thereafter until reaching the last day of the disability’s
maximum allowance or end of the medical disability period, whichever comes
first.
All disabilities will be considered one period of
disability unless the disabilities are due to entirely unrelated causes
and are separated by a return to active employment on a full-time basis,
or availability for such employment as shown on the out-of-work list
provided under the collective bargaining agreement that covers the
Carpenter.
FOR DISABILITIES ON OR AFTER JANUARY 1, 2012
In order for an active Carpenter to qualify, the following requirements must be met:
- The disabled status must be certified by a Physician who is a medical doctor (a chiropractor is not considered a covered physician).
- The written certification of the disabled status must be submitted to the Administrative Office not later than 90 days following the date the active Carpenter became disabled or 60 days following the date eligibility coverage terminates.
In the event that you become disabled, notify the Administrative Office in writing of this fact at once.
LIMITATIONS
This Weekly Disability benefit is subject to the following limitations:
- The amount of weekly benefit will be reduced by any benefit to which you are entitled from any other group coverage, state mandated disability or other governmental plan whether
funded by employer or employee contributions.
- No period of disability shall be considered to have started until the day the individual has been seen and treated personally by a Physician. In order for benefits to be payable you must be receiving regular care and be personally seen by the attending Physician at least once a month.
EXCLUSIONS
No weekly Disability benefits are payable for::
- Plan is notified of a health related cause that is the source of the injury and is a protected source of injury under applicable federal law (for example, the Health Insurance Portability and Accountability Act).
- A disability resulting from war, or any act of war.
- Any injury sustained or sickness contracted anywhere except within the United States, its territories or possessions, Canada or Mexico.
- A disability resulting from an airplane flight except as a passenger of an aircraft having an airworthiness certificate and operated by a licensed pilot.
- A disability resulting from the commission of a felony or engaging in an illegal occupation.
- Any disability directly related to the continuing use of alcohol, barbiturates, hypnotics, LSD, or any type of addiction, as determined by the patient’s medical records.
- Accidental bodily injury arising out of or in the course of employment, or sickness entitling you to benefits under worker’s compensation or similar legislation.
- A disability resulting from work for remuneration or profit.
TERMINATION OF BENEFITS
Weekly Disability benefits will cease immediately upon the occurrence of any of the following events:
- A return to work, or being released by your attending Physician as able to work (there is no “light duty” in Bargaining Unit work). Placing your name on the “out-of-work” list will be construed to
mean you are able to return to work.
- Termination of the benefit by the Board of Trustees.
- Termination of your Eligible Individual status under the Plan, even if COBRA continuation coverage is selected. The weekly Disability Benefit is not provided to anyone enrolled in COBRA
continuation coverage.
- Entering into any type of work for profit, whether it is bargaining unit work or not.
- Certification by your Physician or the Trust’s medical consultant that you are no longer unable to work.
- Expiration of the maximum benefit period as described under “What are the Benefits?”.
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